The authors and an accompanying editorial acknowledged that while the study wasn't conclusive, it added to an important discussion around the safety of community fluoridation for expectant mothers.
"No single observational study provides a definitive test of a hypothesis," wrote editorial author David Bellinger, a professor of neurology at Harvard University.
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The authors acknowledged that the study had several limitations.
First, the urinary fluoride samples collected could have been affected by behaviours that weren't controlled for in the study (e.g. consumption of fluoride-free bottled water or fluoride-containing toothpaste prior to sampling). The samples may also not precisely reflect foetal exposure to fluoride throughout pregnancy.
Second, the fluoride intake data did not measure actual fluoride concentration in tap water in the participants' homes. Rather, it was an estimate of fluoride intake based on self-reported beverage consumption, and did not include fluoride from other sources, such as dental products and food.
Reproductive epidemiologist Michael Davies from the University of Adelaide said the study was not appropriately designed.
"Neither the method for collecting maternal fluoride exposure data nor the method for calculating total fluoride exposure have been validated, making the size and source of associations unreliable," Professor Davies said.
"If you look at the figures, it's only the individuals which have the very highest levels of fluoride whose children have any IQ lowering, and it's a pretty small drop."
While the authors report a 1 mg/L increase in maternal urinary fluoride is associated with a 4.5 lower IQ score in boys, Professor McAlonan said the average difference in fluoride levels between people living in low- and high-fluoride areas is about 0.3 mg/L.
"Also, if you look at average IQ in the children from fluoridated and non-fluoridated groups, these are virtually the same: 108.07 vs. 108.21 respectively," he said.
So, there we go. Our resident anti-vaxxers using their same lack of understanding of science on fluoridated water...